3740 Knoll Ridge DrBLDG. PERMIT N0.
01-3210 Bldg. Permi
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Tzmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 Sewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
0 CASH RECEIPT 0
CITY OF EAGAN
. 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19 -?" ,
RECEIV6q //'
FR0/4?rV' ?C. .
AMOUNt
. $ ?? I '
& DOLLARS
too
`- • White-PaYers CoPV
Yellow-Posting Copy
Pink-File Copy
Thank You
B Y l ?_ ??
? CASH RECEIPT ?
CITY OF EAGAN
• ' 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE ? i 1g ? I
necE1vec
FROM
AMOLNT
$ ?--
Ee DOLLARS
7
oo
E]CASH q CHECK
FOR
I
. . I ?? `.
NUND CODE AMOUNT
i
1 ?
i
I!
1
? L
Thank You
N9 7791. 57,
BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN Remarks
Addition ROSE HILL ADDITION Lot-
Owner Street 3740 Krioll
_Blk 1 Parcel 1v v-rvvv v
Drive Eagan, MW 55122
Improvement Date Amount Annual Years $L Payment Receipt Date
STREETSURF. 1986 2874.29 574.86 -2 -2 .
STREET RESTOR.
GRADING
SAN SEW TRUNK 1985 576.80 38.45 15
SEWER LATERAL 1979
sew, ss, w lats se 1986 .6089.26 1717-85 9 ,
WATERMAIN
WATER LATERAL ? 9179
WATER AREA 1985 576.80 38.45 15
4.??
t-I
? STORM SEW TRK 19$5 1067.00 71.13 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET IIGHT
WATER CONN.
BUILDING PER.
SAC
PAR K
. ? _ . . . CITY OF EAGAN
• 3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55121
PHON E: 454-8100
BUII.DING PERMIT Receipt ?
Td b,e"used for Est Value i- ' Date ,19
Site Address ' OFFICE USE ONLY
Lot BlOCk SBC1Sub. On Site Sewage _ Occupancy
MWCC System _ 2oning
Parcel No. On Site well _ 7ype of Conat
City Water _ (Actuan
NAmo (Allowable)
3 Addee35 * of Sto?ies
Length
° City Phone ' Depth
Total
S
F
, p Name .
.
Footprint S.F.
z
0 `
Address _
APPROVALS
FEES
1- City Phone Assessments _ Permit
F ¢
F W
Name water/sewer
Police _ surcnarpe
_ Plan Review
z
i -
Address Fire - SAC, City
u= - Engc _ SAC. MWCC
C W City Phone Planner _ Water Conn.
Council _ Water Meter
I hereby acknowledge that I have read this application and state Bldg. Off. _ Road Unit
thattheinformatiOnisCOrt'eCtandagreetocomplywkhallappliCable APC _ TreatmentPl
State of Minnesota Statutes and City of Eagan Ordinancea Variance _ Parks
Copies
Si9nature of Permlttee TOTAL
A Building Permit is issued to: on the express condition thet
all work shall be done in accordance with all epplicable State of Minnesota Statutes and Ciry of Eagan Ordinancea
Building Official
Permft No. Psrmit Holder Date Telephone ?
Plumbing
?
H.V.AC. !
i L?-L
Electric -
Softener
Inspectlon Date Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg. _36 ?
Rough Htg. 0
Isul.
Fireplace / 041
Final Htg.
Final Plbg.
Bidg. Final
Cert.Occ.
Temp. LP
Deck Ftg.
Deck Frmg.
WeII
Pr. Disp.
. _ ,
PERMIT #
PLUMBING PEAMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTRAC'x PRICE PHONE: 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot ' Block SeC/Sub
Res. New
m Name Mult Add-on
.S Address Comm. Repair
c City Phone ' Other
_ Name
3 Address
O CitY
FEES
COMM/IND FEE - 1%OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
MINIMUM - COMMIIND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYONO $1,000.00)
/ - .
SIGNATURE OF PERMITTEE
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
.T_Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
SoRener - $5.00
wen - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL:
FOR: CITY OF EAGAN
MECHANI L PERMtT RECEIPT # ?
CITY O AGAN
C, 3830 PILOT KNOB RO D, EAGAN, MN 55122 DATE:
Site Ad ess `' J +
?
Lot Block Sec/Sub BLDG. TYPE WORK DESCRIPTION
Res. New
I m NamM --- Muit Add-on
Comm. Repair
Co.
76 Addr"s
c City ?0 ? ANE TRA?one _ Other
INVER E HTS., MN 5507 FEES
? Name ' ? V RES. HVAC 0-100 M BTU - $24.00
? c AddrES9,r? ADDITIONAL 50 M BTU - 6.00
p City Phon? (RES. HVAC iNCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEkMIT) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
ForCed Air ? G M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMOOELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE _ 20.00
STATE SURCHARGE PER PERMIT .50
Vent CFM
(ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # 0 BEYOND $1,000)
Other
FEE: s- - • • '
S/C: o S1GN/#TURE OF PERMITTEE
TOTAL: ~?7 5 ?
FOR: CITY OF EAGAN
CITY OF EAGAN
3630 Pilat Kncb
? O. Box 21199
gan; MN 55121
wner
lliiui e Ad dress:-
mber.
Conn. Chg: 525. OOPd.??_W1%Vn9: . .
Acct Dep: 1-`•.l?Gn? A:n0"^0 ra?j 16[t8ldf?i?s` -
Permit Fee: IR?C
Surcharge: • ? - ? ??e@ t? ?plY wiih Ihe City of Eagan •
Tr. Plant ?^?
Meter. /1,?? ,.?.,??i??
Misc.: Brf? -
WATER SERVICE PERMIT
CITY OF EAGAN
3630 Pllot Knob Road
Eagan, MN 5512i Permit No:_
P.O. Box 21199
Meter No: _
Reader No:
r.
5ite Address: „ ?.. ,.....?.? ?.
?,ruc+`?ue? Zer -. - -•-- - - - ,
Flumb3n -
plumber.
:
Ch
C
nn 5'?5 •?U' '' Zoning:
g
.
o ?
Acct Dep: 15.0 4 :? No. of Units:
rmitFee:
P i'0? C11
e ,
•5Q d I agree to comply wllh the Ciiy of Eagan
Surcharge:
Tr. Plant 15i? . 049c', Ordinances.
Meter.
rj7
CITY OF EAGAN SEWER SERVICE PERMIT
3630 Piiot Knob Road p??MIT Na.: --
p p, Box 21199 DATE:
Eagan, MN 55121? 1
Zoning: a'? No. of Units:
?ruce Marcia ?Brekke
Conneciion Charge:
wrih ?a?lry of F.a98n
l
m
p
co
Y
agree to
, pccount Deposit:
tnances.
lyd permit Fee: ?-
Surcharge: r-
Misc. Charges: r--
3y Total:
Date of Insp.: pate Paid: q
Insp.:
Date: 9-9-87
Permit No:
Road Meter No• ' ? -5 Size:
Reader No: O Daie: v ' 8$
WOW am?
9021
, . . .
(ttxtif iratp uf (Orrupttnry
titp of (Eagan
apprtviPttf of lltilbttto jwPl'#iOtt
Tlrfs CertrJtcate issued pursuant ro the reguirements of Seclion 306 of the Uniform Building
Code certlfying that at the time of issuance this structure was in compliance with the various
ordinances of tlee City regulaling building conslructiort or use. For the following:
U. Chsafinuoo "F 7JrRS:?_'' Bldg. fbrmit No. I3cxT?
0-pa-y rra
ZoniaB Dwxwt "i
,?.
Type Cma 0
owna CtaMMM 3 Ww..r_" ;9wi:7- ? naa,,. 1329 J C?n'.;Y IW8. EtM
?'•"?>0 ti.^r?C? ?Zi?
??: J! ;,=;
E? l-1?IL Alnl
i??
guildn AMms .
_ ,
Locshty ,
.
'
-MlA
o.u: ? RY 26,
Building O(6da
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN No- 138 3 4
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55127
BUILDING PH ONE: 454-8100 7?oq,D
PERMIT Receipta /
Tobeusedfor SF DWG/GAR EsLValue $158,000 Date .TUNE 29 ,1987
SiteAddress 3740 KNOLL RIDGE DR
Lot $ Block 1 Sec/Sub. ROSE HILL ADD
Parcel No.
BRUCE & MARCIA BREKKE
? Adtsress - 132 JURDY RD
°? City EAGAN phone 454-7302
o Name SAME
?Q Address
? City Phone
ww Name PLANCO INC
_? Address 3435 WASHINGTON AVE
aW City EAGAN Phone 452-0724
I hereby acknowledge that I heve read this application and state I
that the information is conect and agree to complywith all apDlicable
Stale oi Minnesota Statute and City of Eagan OrdinanCes.
5ignature of Permittee ?d.?!
A euilding Permit is issued to: BRUCE & MARCIA BREKKE
all work shall be done in accordance with all appl' abl tate of M
Building Official ---Ar
OFFICE USE ONLY
OnSiteSewage Occupancy R3
-
MWCCSystem J Zoning R1
On Site Weu Type of Const v_
Ciry Water X (qctuaq
(Allowa6le) ?
# of Stories
Length
Dep[h ?(•/.
S.F. Total
FootDrint S.F.
APPROVALS FEES
? 677.$0
Assessments _ Permit
Water/Sewer _ Surcnarge 79, 00
Police PlanReview "A"iA_75
Fire _ SAC, City 7 flfl !lp
Engc _ SAC,MWCC 575_00
Planner WaterConrt 595_(l0
Council _ WaterMeter 67.00
Bldg Off. _ Road Unit 305, 00
APC Treatment P1 1 Rn np
Varience _ Parks
Copies
TOTAL 5
on the express conditfon that
Statutes and City of Eagan Ordinances.
/'1?,31F?2 REQUEST FOR ELECTRICAL INSPECTION
/ See instruchons for comolatmg lnis lorm on beck ol Vellow copy.
? 6"9 4 7 2 "X" Be/ow Wark Covered by 7his Request
EB-C00001-06
AdJ fleo. Tvpe ol Bmleine Aool,ancm wired Enuiumam Wven
Home Range ' Temporary Service
Duplex Water Heater Lighhny Fixtures
Apt. Bwldinq Dryer Electne Heatin
Commercial Bidg. Fumace Silo Unbade.r
Inclustnal Bldg. Air Condrtioner Bulk Milk Tank
Farm otnr, oc,i v Oiher ISnec,fyl
t r Suemfy Other O?h?r
ompu[e lnspection Fee Below
N Fee Service Enbonce5iae d Fee Feeders/5ubfewders b Fre Cucwts
0 to 200 Amps 0 to 30 qm s ? 0 to 30 An >s
Above 200 Arnps 31 to 100 qmps 31 to 100 Am
p Swinming Pool Above 100_Amps Above 100_Ampy
Transrormers Irngation Booms Partia6"Other
Signs SUecial Inspection Sy'?
?
p
TOTAL FE
pe?rks J t !'?
HouBh-in [he Elecv?
ns0ector, hereby
cer?i?y that the above
Final D
nt
e. mspeetmn has been
?
/
Thia repuest voitl 18 monlhs Irom ?
Th.s reQUest vmd
18 nwnths fmm
6-9472
Fe sst Uate ire N& flooph-m Inspecbon R;.W
?/ Reqwre ?HeaAy Now IT Nntity Inspec-
?No [or When fleady
? ? es
I
icensed Elec[nr,al ConVactor I hereby requestinspacvon ot above
? Owner electrical work mstalled ei:
S??ddres ?x or Route o. c?? g g*?
ect?on o. Township Name or No. ange No. Coun[y
Occupa I P T)
'm?? Ph ie No.
4-790 9.
Power Sup Iner Adtlrrss 6 ,? .?? Q
8
EI 1 c or ComDany Namel
???1???? ELEClRiC Cn v
? actor's Lmense No.
p r'
Ma?M1ng r ( ri?ta oi'pf.'DWere?lMnk?? ?a?s?a?leuonl
A.uffior¢e tu e /p qd atwn) Phnne Numbar
MINNESOiA STATE 90ARD OF ELECTflICITY . THIS INSPECTIDN REQUEST WILL NOT
Griges•Midwey Bldg. - Poom N•191 BE ACCEPTED BY THE STATE BOARD
1821 Universitv Ave.. St Paul, MN 55104 UNI.ESS PROPEN INSPECTION FEE IS
Phone(6t2)642-0800 ENCLOSED.
?L RESIDENTIAL
BUILDING PERMIT APPLICATION
J CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
659-681•4675
Naw ConaUUCUon ReauiremeMs
• 3 registered site surveys slwwing sq. R of lot, sq, ft. of Iwuse; and all roofed areas
(20% maximum lol coverege allowed)
• 2 coples of plan showiig beam 8 window s¢es; poured found design, etc.)
• 1selMEnergyCalculations
• 3 copies W Tree Preservation Plan if lot platted after 7/1193
• Rim Joist Detail Options seleIXbn sheet (61dgs wilh 3 or less units)
DATE -t- 8 U -Z-
SITE
TYPE
?ULTI-FAMILY BLDG _Y t!N
FIREPLACE(S) _ 0 ?1 _ 2
APPLICANT /tti--!• .LVI(%•
STREETADDRESS •S CITY ?)vs0Sviltc STATENI_uJ ZIPr-r33-+_
TELEPHONE # ?qs??U?--6c1SyCELL PHONE # FAX #?G??",?=L?? ?
PROPERTYOWNER'?wUCe. LfC?K? TELEPHONE#Ks-f) 4 5-N-33oz
-----------------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RE5IDENTIAL BUILDINGS ONLY
Energy Cotie Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNP:S01'A RLJLL:S 7672
(J submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Su6mitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: ____
Plumbing system includes:
Mechanical Confractor:
Mechanical system includes:
Sewer/Water Contractor:
RemodellReoair ReCUlrements
• 2 copies of plan
7 set af Energy Calculations for heated additions ?
• lsitesurveyfore#erioraddilions&decks
• Indicate if home served by seplic system for additions
VALUATIOtJ-W'1 l ? I??
_ Water Softencr
Water Heatcr _
No. of Baths
Air Condirioning
Heat Recovery System
Phone # ,
Iawci Sprinkler
No. of R.I. Baths
Phone #
Phone #
ree: $70.00
-°----------------------------------°-----°----------------°-------°-----°--------------------------
I hereby acknowledge that I have read this application, state that the information is correct, and al
with all applicable State of Minnesota Statutes and City of Eagan Ordinapces. 11?14
Slgnature of Applicant
s
OFFICE USE ONLY
Certificates of Survey Received Tree Preservation Plan Received _ Not Required _
Updated 4l02
OFFICE USE ONLY
.
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage O 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch(screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors
O 34 Replacement 'Demolltlon (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (newbldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) _ plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fueplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insularion _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New ConsWetion Reauirements
• 3 registered site surveys showirtg sq. ft. oS lot, sq. ft of house; and atl moted areas
(200/o maximum lot coverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preservafion Plan'rf lot platted after 711193
• Rim Joist Delail Oplions SeleCtion sheet (bldgs with 3 ar less units)
RemodellReoair Reauirements
. 2 copies of plan ?
• 1 set of Eneyy Calculations for heated additions ?
• isilesurveyforexterioraddXions&dacks
• Indicate if home sened by sepfic system for additiore
DATE -?"a UZ-
SITE
TYPE
ULTI-FAMILY BLDG _Y V/N
FIREPLACE(S) _ 0 zi _ 2
APPLICANT IkY?- T.V1C•
STREET ADDRESS \11y-+ N lCo1?e,? NE• S CITY '60d1lSv? tl, c STATE NI_W ZIP rS-33-:?_ _
TELEPHONE # 00CELL PHONE # FAX #?°?'??`??.7-!?????- `
PROPERTYOWNER'?WVCC-. IICz.??- TELEPHONE#(Cr?Ns4-33az
------°---------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Cocle Category _ MINNFSOTA RULES 7670 CATEGORY 1 MINNF.SOTA RUI,1S 7672
(4 submission lype) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submi[ted
. Energy Envelope Calculations Suhmitted
Plumbing Contractor: ______ Phone # 21T
Plumbing system includes: _ Waler Softener Lawn Sprinkler ?je• p ?
Water Heater No. of R.I. Baths ?
No. of Baths
BY
Mechanical Contractor: Phone #
Mechanical system includes: _ Air Condilioning Fee: $70.00
_ Heat Recovery System
Sewer/Water Contractor. Phone #
--------------------------°--------------------------------°--•-----°---°---°------•---°----------------------------
I hereby acknowledge that I have read this application, state that the information is correct, and agre comply
with all applicable State of Minnesota Statutes and City of Eagan Ordina ces. , /
G i
Signature of Appllcant '
s
________--------------_------------ ---_---°----------------------------------------------------- °------------
OFFICE USE ONLY
Certificates of Survey Received Tree Preservation Plan Received _ Not Required _
- Updated 4102
VALUATIOA
OFFICE USE ONLY
r
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 38 EM. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
O 06 04-plex ? 12 12-plex PIbg,Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demalish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Fountlation) ? 45 Fire Repair
? 33 Alteration ? 37 Demofish (Bldg)• ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPEC710NS
_ Footings (new bldg) FinallC.O.
_ Footings (deck) Final/No C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain TIle pther
Roof _ Ice & W ater _ Final _ Pool
Ftgs _ Air/Gas Tests _ Fina1
_ FIamin6 _
Siding Stucco Stone
_ Fireplace , R.I. _ Air Test _ _
Final _ Windows (new/replacexnent)
_ Insularion _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
W ater Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
!KYPS': PAYMK3IP OF FEE AT TIME OF
APPLIcATIorr nors Mr oorSrr=
APPI20VAL OF PERMCT.
itvsPncizorr oF sEWER Arm/at WmMM
iNS'LATSATTQP]$ WjI,L P1DT $E $QHED-
UIkD iJNPII, PERNIIT AAS BE21
APPRUVID.
• P ease Print
<
1) PROPERTY ADDRESS: •-
LEGAL DESCRIPTION:
IF E}ffSTING STRC'CMRE, DATE OF ORIGINAL BL?ILDING PERN1iT ISSL'ANCE: '
(Nbn Year
PRESEN7P ZONING/PROPOSFD C'SE:
? COI"MERCIAI./RETAIL/OFEICE ? R-1 SINGLE FAMILY
C3 IML?STRIAL ? R-2 DLPLEX (1t.v Dnits)
? INSTI7L"fIONAL/GOVE?NT R-3 'It7WNFIOUSE (Three + Units) ( Units)
. ? R-4 APARZMENt'/CObIDOMINIUM ( Units)
2) ?
NAME: Al'(/CP
AwnxESS: ? 3 2 -j
CITY. STATE. ZIP:
- ?
PHONE: L/'j''/- 7? p 2
3) NAME:
ADDRFSS:
CITY. $TATEr ZIP:
PHONE:
- 6 2 S c.? MASTER LICENSE# 3 2 T' L-=
4)
L'1l"ll•!G:
P,DDRESS :
CITY, STP.TE. ZIP:
PHONE:
riiumers t,icense:
Active
Expired
Not recorded
Sta Ir'iitial
'5) ?? a• ??• :a - s - ??
oOrNECrzotv TC) ciTr sEWM ? wrNECriorr TO cixY waTER ? aiFM 6) ?? ' • i• C] PLEA,SE HOI,D APPROM PERMIT F'UR PICK-[JP BY ONE OF ABOVE
? PLF.7iSE MAIL APPROVID PERMIT TO 1, 2Xf3?4, AHOVE
(Circle one)
tI
1.??,/'$'s??? ?? ? 9 ?& "/Y
7) EMM
c??ir=? __ _ 5 5"? 2 7
:FOR CITY USE ONLY
PERMIT # ISSUED
& i /
Pd w/Bldg. Permit
$ $.
$ $
S G?7•r9f S
$ $
S c
S
$
s (o Z S-? a-?
$
c
$
$
s C}io
FEES:
/0 -7 ? SEWER PERMIT (INCLLDE SURCHARGE)
WATER PERMIT (INCLUDE SURCAARGE)
WATER METER/COPPERHORN/OUTSIDE READER
WATER TAP (IIVCLLDE CORPORATION STOP)
SEWER TAP
ACCOUNT DEPOSIT - SEWER
ACCOUNT DEPOSIT - WATER
$ WAC
$ SAC $ TRLNK WATER A55$SSMENT
S TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRLNK SEWER
$ LATERAL BENEFIT/TRLNK WATER
$ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$_ TOTAL
SJ z-
271.
RECEIPT RE EIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK W2THIN PUBLIC
Q
ROADWAY" MLST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SLBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE : ?? ? /? 7
? ? ?:5 K
7987 BQILDING PERMIT gPPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
IHCGIIDE 2 SSTS OF BLANS, 3 CERTIFIC9TES OF SDRVBY, 1 SST OF ENERGY CALCQLATIONS
NOTfi: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MDST DESIGAAYE AHICH AD?RESS
IS DESIRED.!
? IVO CHANGfiS WILL HS 9LLOiN-SD ONCS BIIILDING PERMIT IS ISSOED.
M[TLTIPLE DWELLIHGS - RFSZDENTIAL RSNR9L ONITS FOR SALE ANZT3
INCLUDE 2 SETS OF PLANS, CERTIFICATB OF SIIRPSY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMFIl:RCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTiIRAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
1 1
To Be Used For: 10° Valuation:-4"70? Date:
Site Address
Lot ig Block ?
Parcel/Sub ?C-Q.2 4"
Owner/l'ik/lLi ?r /1'IARC'II? f,rzlck?
U
Address/3911 (ZOf1-o
City/Zip Code s/}6 f}Al
Phone 4e7?y - 730
Contractor jR/ UGL J.nileit+Ce
Addressig29 jURAu ?f!u"
City/Zip Code??J6Apv, MN
Phone 0 Z
Arch./Engr.
z .
Address 3?/,3S WA51j41o/cJ?6W ?V 2_
'!? --9-E- 7
Or, Site Sewage_ Occupanry 9.3
M4dCC System ?' Zoning 9.1
On Site Well Type of Const
Ci.ty Water ? (Aetual) ?
(Allowable) ?-
# of Stories
Length (nB
Depth !0 4
S.F. Total
Footprint S.F .
APPROYALS FEBS
Avsessments Permit ?,7 7 -
Wa.ter/Sewer Surch,arge 7q,
Police Plan Review 133b-
Fire SAC, City 100.
Ecigr SAC, MWCC
•
-52 5-
Planner Water Conn SZS
Council Water Meter (07.
B?.dg Off Road Unit "?06-
APC Treat.ment °1 I bD.
Variance Park:;
Copies
TOTAI. ? 7 .
City/Zip Code /yp,v SSl? Z
?
Phone # cf
?-
(?
r
?????=2(?xfZ = S?Z
?
?-
(b x (? -= (go
. ,
j?? 5 (0 <T-
' MINNESOTA STATE ENERGY CODE CALCULATIDNS
BASED DN CHAPTER 5 OF THE
? • MODEL ENERGY CODE - I983 EDITION
Adoption Effective 1/1/
Owner12?
^ S(te Address
Contractor
Phone
Date
8uilding ClassiFication: Type Al (Single Family 6 Duplex)ype A2(Residential)
NOTE: Complete pages 3 and 4 first. ; (3 stortes or less (Other) (Over 3 stories)
GENERAL INFORMATION
1
1. Bui lding Perimeter 41N ft.
2. Wall height (ground to eave) ft.
q 2•
3. I. x 2. (above) gross wal l area }i=t6fft.
4. Building dimensions (L) 'r- X (W)
ft.
5. Square foot area of rim joist - Floor joist size (2 x ? )-I^)
)4?4? X Perimeter = Rim oist area =
12 l?j0
6. Doors - Area 2L-51'IU
Thickness
Type of Construction
Manufacturer
7. Total door's perime[er
8. Windows: Manufacturer ?"M, ic0e_'A'?, State approved
U factor
TYPE SIZE AREA (Ft.2)
' EACH
9• Total f[.Z Glass So4Id
10. Fireplace area; Width X height =
_ 1,p71Zobft.2 roof E floor area
NUMBER OF TOTAL FEET 2
UNITS
X =
Ft.2
11. Exposed foundatlon: Height X Perimeter X I'90 = I 2?1 9) F[.Z
COMPLETION OF THIS FORM IS REQUIRED FOR AlL NE COFJSTRUCTION, MAJOR REMODELING AND BUILDINGS BEIP
MOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USED.
k121/4
44 7 -? &-', 45;7
/JJ,c? ftZ
in. U factor A +tr' 14"1 .
Perimeter ft.
Phone
F,
WORLD L I F E INSURANCE COMPANY
HOME OFFICE 3003 771h Ave SE, Mercer Island. Washington 98040
MARK C. THEISEN
3435 Washington Dr.
Eagan, Minnesota 55122
Bus: (612) 452-3394
Res: (612) 432-4993
If you don't smoke you should be paying a lot less for your
auto insurance, your fire insurance and your life insurance.
Our research has revealed that people who don't smoke live
longer, have fewer accidents and fewer fires than smokers.
So, Farmers believes you should pay less for this insurance
than people who smoke.
Call me today to see how Farmers Non-Smoker Discounts can
save you money on your insurance*.
Your Farmers Agent
*EVen if you do smoke, you can still get
a good deal from Farmers.
• MEMBER FARMERSINSURANCE GROUP
12., Framing area = 10% of gross wall area.
P3. uross wall area 3,5G?i 13 L5 ft.2
Window area A -?4 I D 2
ft. U windows U x A= Rim joist area A 1?d ro ft.2 U rim joist U x A=
Door area A ?j (0 ft.-
`p? 1 2
btpepfi3ce area A f 1l{?j ft.
Exposed foundation A ? 7:7, ? ft.2
-T
9
Framin9 area A ft. 2
Net wall area A ,?. 109) ft.
14
15.
ISA.
156
I5C.
ISD
U door area = U x A=
U firepl-dre =U x A =
U foundation ?-4" U x A=
U framin9 area U x A= ??'?.'T,!.
U wall = lo 4"3 U x A= /L
(138) 70TAL . . . . . . . . . . U x A =11
i
Gross wall area ?C 0.11,(A-1 single family & duolex
(13. above) .
x 0.23 (A-2 other residential)
x .23 (Other buildings)
x .28 (Over 3 stories)
a 0??54x U Code
- J ."_. . .'_
Ceiling framing area (Ap) equals 10% of ceiling area
= allowable U x A/Code
w?4?1 fBTUN Must be larger than
??-°F. 136 above
( or the same as)
Gross ceiling area = (L) x(W) = I ??? ?z,5 ft.2
Joist area (Af) = 10o ceiling
Net ceiling area (AC) (15A -
U ceiling x A c= t0 'Z2
U f rami ng x A p= ? 073
--
TOTAL U x A .................
area = I 72? ft.2
158) ft.2
_ x
_ x_ -7?
. . . . . . . .. . . . . : . . . . ... .
16. Ceiling area (15Ay'x 0.026 (A-1 single `amily & duplex - code allowa6le U x A
(„ . _.
x 0.033 (9-2 other residential)
x 0.06 (other)
A(15.4) I1 Ipi I Zs x U,(codel= _I????C?BaFN M(orbth1ersamehas)l5D?(ahove)
NOTE: Use U and A values obtained from pages 1, 3 and 4.
CER71F1CATION: I hereby certify that I have calculated the "U" factors and "R" values
herein and that the bullding here described meets or exceeds the S[ate of Minnesota
Energy Conservation Act. I
Date ? Signature
?
F
WORLD LIFE INSURANCE COMPANY
HOME OFFICE 3003 771h Ave SE, Mercer Island, Washmgton 98040
MARK C. THEISEN
3435 Washington Dc.
Eagan, Minnesota 55122
Bus: (612) 452 3394
Res: (612) 432-4993
If yoa don't smoke you should be paying a lot less for your
auto insurance, your fire insurance and your life insurance.
Our research has revealed that people who don't smoke live
longer, have fewer accidents and fewer fires than smokers.
So, Farmers believes you should pay less for this insurance
than people who smoke.
Call me today to see how Farmers Non-Smoker Discounts can
save you money on your insurance*.
Your Farmers Agent
*EVen if you do smoke, you can still get
a qood deal from Farmers.
. MEMBER FAqMER51NSURANCE GROUP
4??-l - ?ko5
NI
N?k -2L-ffF?
(IZ)
?? d0 x( GJD
10 , ZoCo X? e2o) =?? 'I z
3Z±t.g?z ?-?o4- Iu? =
=-
I?17z
I 1 coF;Kn
U ??T. J = ?- ' C??
- -
c23 ? 127?2 = 2?1_
?? Z3 --- Iz? I= I 2-
G?I?-??° loX 1= f? ??
G 3?- = `Z?' K 1= D4-
G3?, - 2? X I= zi?o
??P ?-2 ?- I ^ 24X ? - z ?-
Af 4L 1 -?5 _ -72- X ? -- -7 2Ia
? w2-.e}- = 2.0 ?, I= Zd ,O
P?p53o- 3 - ?r2X -tiF t n
1'??11-? - 2`?? I = ?d t ?_
co
?---
:-
'`1, YJ?.
?.
2 4?
FARMEYNEW WORLD LIFE INSURANCE COMPANY
/08? HOME OFFICE 3003 771h, Ave SE. Mercer Island. Washington 98040
MARK C. THEISEN
3435 Washington Dr.
Eagan, Minnesota 55122
eus: (612) 452 3394
Res: (612) 432-4993
If you don`t smoke you should be paying a lot less for your
auto insurance, your fire insurance and your life insurance.
our research has revealed that people who don't smoke live
longer, have fewer accidents and fewer fires than smokers.
So, Farmers believes you should pay less for this insurance
than people who smoke.
Call me today to see how Farmers Non-Smoker Discounts can
save you money on your insurance*.
Your Farmers Agent
*EVen if you do smoke, you can still get
a good deal from Farmers.
MEMBER FARMEiiS INSURANCE GROUP
, '"dALL •
SEC?IOH
stvo
SECTIOH
I
:1ID VALL
S£CtION ?
a ui
' JO[ST
-'lALUE • U VALUE
Inslde alr [ilm .68
Idterior vall (pall) U . i
Insulatlan .
Sheathtng -Z,p(D Q 4,3
• I
Slding
. ? • ..
. , -? • .?---
Outllde atr fllm
R tOYAL Z'?.43 .
Inatda-ale tlim ,gg
Inkerioc vall ??3' •
Aid seud (fa") R' .(,.??6. ?(Framing) U + a .
Sheaching
Slding .l07 •49s
Outslda atr Etlrr t)
Q 70TAL I b,g ? • .
Inslde atr ftlm ' R- .68 InCarlac wall • ,
Ln'lulation ' .(Nall ) U . & .
31ii• tn
Extartot vall ring . .
Ext?rlvc alr Ellm' Il .?t?l •
- \
' 0. tDTAL
? inteclor alr (tlm Ru .68
_ inaulatton (?sDb •
, l} lnah.eoft woud R-1,88 (Rim U
' Jo1st)
_ Slieathing
_ Exteclor wall cvvering ,fo7 ? .
_ Extertor air Ellm
• R+ ,11
__
'
.
R TOTAL
? Ioteiloc alr Eilm Ra .68 ' .
? Insulatlott . 'S,Ub
_ Foundaelon ( Z g •
A
•(Fdn.
) •
U .
_ Extaclor •lr Lllm
, R° .17
R TOTaL
.
?Esposad 9luck ^?
F
WORLD LIFE INSURANCE COMPANY
HOME OFRCE 3003 77th. Ave SE. Mercer Island, Washington 98040
MARK C. THEISEN
3435 Washington Dr.
Eagan, Minnesota 55122
Bus: (612) 452-3394
Res: (612) 432-4993
If you don't smoke you should be paying a lot less for your
auto insurance, your fire insurance and your life insurance.
Our research has revealed that people who don't smoke live
longer, have fewer accidents and fewer fires than smokers.
So, Farmers believes you should pay less for this insurance
than people who smoke.
Call me today to see how Farmers Non-Smoker Discounts can
save you money on your insurance*.
Your Farmers Agent
*EVen if you do smoke, you can still get
a good deal from Farmers.
, MEMBERFARMEFSINSURANCE GROUP
? 3 • ?
?EILI1Iri 'a(iN 'IEfITP,II ATTIC SPACE A90VE
? 1;+ u-
f RAt9l flG CE [ L l tIG
i
. n?.3
Air Fitm 0.61
[nsulatlon ft to
Jalst ,
Ce111ng
Atr Fllm 0.61
Ta ta; H_
U ¦ fi . ,b7z
FL.4T AQQF OH CATII aAI CEILitIG
R 9All1E
FRdIIIIIG , CEiL[NG
, a.61
,
?-?
?------_?__,
•.,r_?
.
0.17
Inslda a1r ftlm 4•61
CoIlin •
Jnist Istu
?ntulAtian
Ir tpm
aoaf J4cking •
Tnaulatian
Bu1.1 t-up roof
Outside air film 0.17
• Total R
? . . . ' ? .
. ?•U
1lndow inflltration .5 cfm/llneal fooE of crack • ?
lesidential door lnfiltratian 0.5 cfm/square foot or daor anJ minimum cade'raqulrement
Icn-residential doar 1nPiltration 11.0 cf-in/1lneal foot af Crack
1b 12" concrete block na lnsulation ¦:47•R 2.1 . ?
)b 12" concrete block insulated cores ¦.26 R 3.8
Jb 12" 1lglit,+eiaht 61ock ¦.]Z R 7.1 ••• '
lb 12" 1lghtweight 61ock lnsulated cores a.12 R 9.3
• • '• .
1 single glass.• 1,13; wlth starm,w{ndaw'.54 1 dauble glass ? :55 . • •
J trlple glass • .41 • . ,
111 exterlar waTls and ceilings must have a vapor 6arrier (0.10 parm max.).
;apar harrler must he on the lnsida (heated side) of +iall. .
iapor barriers af the polyethelene thin film hav9 na R vatue.
! )I i . %
, . .
' 0.61
.'
F
WORLD LIFE INSURANCE COMPANY
HOME OFFICE 3003 77th Ave SE, Mercer Island. Washmgtun 98040
MARK C. THEISEN
3435 Washington Dr.
Eagan, Minnesota 55122
Bus: (612) 452 3394
Res: (612) 432-4993
if you don't smoke you should be paying a lot less for your
auto insurance, your fire insurance and your life insurance.
Our research has revealed that people who don't smoke live
longer, have fewer accidents and fewer fires than smokers.
So, Farmers believes you should pay less for this insurance
than people who smoke.
Call me today to see how Farmers Non-Smoker Discounts can
save you money on your insurance*.
Your Farmers Agent
*EVen if you do smoke, you can still get
a good deal from Farmers.
r . ' MEMBER FARMERSINSURANCE GROUP
i / ~ i l~;
L _ ~J I
3 3.19 ~ _ NORTH 4 ~
. I
- I86.97 ~ ~ - - 0 4Z03 - ~ ~ p i . ' - -
- , - ~ O t~
~ - y ~M
~5 o tQ ~ ' ~ d' o
a~ ~ ~ m ~ 2 i ~D
c~ ~ 2
2~ v az5.3 2 ~ ' - -
2 2 ~ , 50.00 ' ' ~ ~ ~ ~ TH
p W ~ ~ NOR 0 ' 1
h' ~ ~ p9 0, o
~ ~'o, ~ s; 3~0 ~ ~ ~ F
~ . ~ X826. 3 .
~,9 Y /
~ 828.9 ~ ' . m X, ~ ~ ~
6 5`~ • 3~~~ p
M ^ \6~~~ ~~F~ S~/ _ ~ ~ p X C+~ ~ ~ - ~ - . .F~ o ~ ~ _ _ . . .
- ~ , _ ~_~.w,, ~ .r.. ~ ~ --t-- ~ 1 3 •s 0 ~ / o a 'h 2 ~ ~ f~ 0~' 6`,J ---------_-~9 ~ X s28.
~ X 6 i o_p 2 ~ ~ ~ ~ ~2 s y ,o p
1 i~ p OS~ 6' ~ ~ ~ ' ~ v 'c9 6' GS t~` p S~ ~22
i p'sa F~ X829.4 1 841.52 ~ ~ ~ ~
e ~ , ~t ~ 6 42 `C , / g EXISTING k ~ ~ ~ U ' _ ~3 p0 830.2 2~ ~ot~
o ~ ~ . ~ 3 I HOUSE ~ ~5 ~i7.6X ;._,320 ~
1 ~ _ ; ~ ~ i~ ~ ~ ~
8 ( ~ ~ ',;3. / 42 ~X 1 ~ G ~ ,
_.__~J 6 0' d ~ c I n i ~ 838.2 X~~' 2' ~ O c'j.~~' a' 0 ~ ~ ~ N53 26 43 IN , 9 g. 3 1
e _ ~ ~P 'X 837.7 9 p C~ k ( , , 29.23 ~ ^ / ,
/ rC ~ 2~ I I? ~ p p~ ~ '
~ v, ~ ~ a v ~ - ~
843.OX 0y'~ / 5~~ p, ~
~e ~P l~ ' r9fl0 6 32' ~ Q ~~~`T - ~ ~ UENOTES PROPOSED SURrACE Df~A1NAGE
'p.~j o~` ~f 38~ - 0 UEIIU1ES IIlO~~ MUNUh1[N~( 5ET SCAIE; l INClI ~ 40 `S s ' 83e g39~eX 1 M NUM~P~T FUUP~U ('f~OPOSEU GA(~/1GE FLUUIt ~ 1 INcii - 30 rEcT ;E rLOOR _ a 4os FEEY
~ S~t ~ es • UEPUtES if~ON 0 8 s42.z 90 '0 ~ s ap ~STiN~ X000,0 UENOTES EXISTING ELEVATION PIlOP05EU LUIdEST ~LUUII ~ b ;-r rLoOii n s..,, rEEr
x . 3g~ EXOUS~ ~ pIZOPDSEU TOP Of ULUGK ~ 2 H (UUU,U) UEI~UTES PROPOS~U ELEVATION ~ lF BLUCK - 8 4--D,9 FEET,
~ ~S~> ~ , ~ ~ 840,0 '
~ - ~ i IIEftEAY GERTIFY TO ERUCE BREKKE TIIIIT T1115 IS A TRUE ANU CUftl 'RUE /1NU CU(2RECT
~ 4_/ REtIIESEI~TATIUfi UF ll SURVEY UF TIIE UOU~JUAIZIES U~: 8 1.6 ~
X841.1 ~
~ ~ din to the recorded Lot Block l, ROSE HILL ADDITI fl, accor g ,ecorded
lat thereof, Dakota County, Minnesota. P .
I11IU OF TIIE LUC(ITI~~I UF A PROPOSEI) pUILUING, IT DOES NUT PUf1PUll1~ TU 51101~! l~ ZT TU SI101-! 1Pin(tOVEI•1EfdTS
~ xa4~o ~ 0{t E~ICROJIC11~~1~~~TS, IF ANY, TfIEREUfI, AS SUf~VEYEU bY h1E, 011 UI~~UER ~~1Y UIIIECT ' t MY UIIIECT SUPE(tV1S1014,
~ ~ TI I1 S I~ UAY UF 1 y8~7, , ~ ,
SIG(JEU; JAI~1E5 ft, IIfLL I~~C. , lC.
REVISED 6-24-87 /
i~ f / ~
j ~ ' DY ; ~ ; ' ~;,~~P,~
~ ~ ~ IInnOLU C, PETE(1SUil, LAiI~ SUII' )11, Ln111) suIivEvoIi
~ ~ Pi11JlIES01A LIC~~~SE I10, 12294 _ 110. 12294
P QJE N B OK / pAGE ' UN 2 61987 ~ cr o, o . J E a 1LL, AM~RH , R. H1LL~ INC.
~ ~73~(? 2 3 8 ~ 2/
! PI E ineers ~ anners / ng / ~ lfneers / Surveyors
. . FILE N0. ' .
~ 8200 Ffumbofdt Avenue ; )tdt Avenue south
_ _ Hiooinfngton, Mn. 65431 812 I 87 170 , 65431 612-884•3029
.
41011°
C! of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit (
#: (/ 0•53
Permit Fee: 0
Date Received -A-44- 13
Staff:
2012 MECHANICAL PERMIT APPLICATION
Date: Site Address: T` I `1 �C" YIsOi C) (,6
Tenant: Suite #:
RESIDENT / OWNER
Name: 1 1 `CkirSYl CI -COOC Phone: Co 5-1- 30 `it _c"'2 j -C,
Address / City / Zip: '3 0 kill ° ( ( re,,c4 ,`A
CONTRACTOR
Name: ' * 1(1 T r
) 0. ` (`_ / 1-
11rn License #: [✓
(.
/
Address: 71-L1 1 CO ki 'fLtA.2's
-i 0- IN) City: /4/6 G rt +'- _
,/� 1 5-.5 --.70
��i )
State: I / l!W Zip: �Phone: 1 b 3- L-( O 7 0
Contact: d\-- Email:
TYPE OF WORK
New Replacement Additional Alteration Demolition
X
Description of work:
NOTE: Roof mounted and ground mounted`mechan c l equipment l aired to. screened b •; ity °:
Code. Please contact the Mechanical Inspector for inform a# r ron pat #ed sci ning methods
PERMIT TYPE
RESIDENTIAL
Furnace
'')C Air Conditioner
Air Exchanger
Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping _ Processed
Gas Exterior HVAC Unit
Under / Above ground Tank ( Install / _ Remove)
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ C TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x 1%
$60.00 Minimum (includes State Surcharge) = $ Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
= $ Surcharge
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) = $ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before
you intend to dig to receive locates of underground utilities. www.nopherstateonecali.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance
with the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printetd)ame
FOR OFFICE USE
Required Inspections:
Underground Rough In
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115987
Date Issued:10/01/2013
Permit Category:ePermit
Site Address: 3740 Knoll Ridge Dr
Lot:8 Block: 1 Addition: Rose Hill
PID:10-64600-01-080
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
James Hunter
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Marcia M Brekke
3740 Knoll Ridge Dr
Eagan MN 55122
(651) 308-9270
Hoffman Weber Construction Inc
3515 48th Ave N
Brooklyn Center MN 55429
(866) 970-1133
Applicant/Permitee: Signature Issued By: Signature
To: City of Eagan
• I
Page 2 of 4
2014-01-29 19:33:14 (3MT)
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
16124542730 From: Chris Janssen
Use BLUE or BLACK ink
For Office Use ?,(�
Permit* � 014"3g
Permit Fee: tic) .31°
a/ii/iy
Date. Received:
Staff:
boom
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �,�—/7-,tj' Site Address: ? l-2 / )LLQ ,J6/ i- - : Unit #:
Resident/
Owner
Name: /.4/7'.<%%.►' /��--r�•z.— Phone:
Address / City f Zip: .2
..-0
Applicant is: Owner Contractor
Type of Work
Contractor
eoalekizoee
Description of work: Z.; �� / /�1.•�� r,
•
Construction Cost: /4"�;c' Multi -Family
Building: (Yes / No )
Company: //l'� -C .
Address:
City: �i'✓'<er'
State: /0/, Zip: `i r Phone: L°�2,'
License #: ''' �-- '"�_,..
.-r•�Cti.--� Lead Certificate #: %%/Jff /•/��
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan Issued a permit for a similar plan based on a master plan?
_Yes No if yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Flans and supporting dominants that you submit are considered to be public information Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are bade secrets.
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.000herstateonecall.orq
1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that t understand this Is not a permit, but only an application for a permit, and work is not to start without a.permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued In accordance with the Minnesota State B
days of permit issuance.
e must be completed within 180
Applicant's P
Name
Page 1 of 3
To: City of Eagan
Pogo 3 of4
2014-01-29 19:33:14 (C3MT)
3 -/co Kt/70 I/ Ridq
DO NOT WRITE BELOW THIS Ric/1w
16124542730 From: Chris Jonsson
/020,13g -
SUB
TPES
Foundation
Single Family
Multi
01 of __ Plex
WORK TYPES
New
Addition
4 Alteration
Replace Repair
— Retaining Wail
Fireplace
Garage
Deck
Lower Level
Porch (3 -Season)
Porch (4 -Season)
_ Porch (Screen/Gazebo/Pergola)
Pool
Interior Improvement
Move Building
Fire Repair
DESCRIPTION
Valuation
Pian Review
(25°!0,__ 100%4
Census Code
# of Units
# of Buildings
Type of Construction
REQUIRED INSPECTIONS
_ Footings (New Building)
Footings (Deck)
Siding
Reroof
Windows
_ Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building'
Demolish Interior
Demolish Foundation
_ Water Damage
*Demolition of entire building - give PCA handout to applicant
Occupancy L j` MCES System
Code Edition , 0-7 SAC Units
Zoning 1 City Water
Stories Booster Pump
Square Feet PRV
Length Fire Sprinklers
Width
Footings (Addition)
Foundation
Roof: Ice & Water Final
`1( Framing
I Fireplace: Rough In Air Test Final
_ ( insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Reviewed By:
11/
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Pool: _Footings : Air/GasTests. _Final
Drain Tile
Siding: _Stucco. Lath Stone Lath Back
Windows
Retaining Wall: , Footings _ Backfill _ Final
Radon Control
Erosion Control
Other:
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
14-649'"(411"'
6
Page 2 of 3